​​​​​​​Low Dose Naltrexone (LDN) Benefit Lichen Sclerosis?

LDN Specialist
Pharmacists Michelle Moser and Dr. Sam Lebsock

Low Dose Naltrexone (LDN) Benefit Lichen Sclerosis?

The question is do you have any experience with treating vulvar lichen sclerosis with LDN and is there any reversal of scarring and or discoloration?  The first answer is yes. When we're dealing with a topical autoimmune issue whether the lichen is in the mouth or in vulvar tissues sometimes  it's due to a toxin exposure. For example like Mercury amalgams which are the silver fillings in the mouth.  They can cause a trigger but usually there's some autoimmune relationship with lichen.  I would still use an oral medication because you need the oral LDN to help modulate the immune system.  You can still use a little bit of topical LDN as well.  

For the scarring and the discoloration, LDN will reduce the inflammation.  Depending on what base that topical LDN is put in we can use it to also help reduce scarring and or discoloration.  Use a very small amount of the topical as needed for itching or the tingling that goes along with the Lichen sclerosis.   Whether it lightens the area really depends on the pigment of the skin to begin with.  

LDN doesn't necessarily bleach the tissues.  It doesn't take pigment out of the tissues.  We have other medications that can help with that that can be combined with a topical LDN if you're most concerned about discoloration of the skin due to the Lichen. Anytime you reverse or at least minimize that inflammation around that scarring perhaps the discoloration will subside as well.  

Lichen is really hard to treat and it's not a short-term fix.  People might not see benefits for six months.  It eventually comes but it's very tricky to treat and it's a long-term type of situation.  A patient needs to have a lot of patience. The patient will need to use the oral medication.  Topical alone is not going to handle it.  Topical can be used up to four times a day but they actually benefited more when they added an oral because it is an immune type of situation.